Reynolds Predoctoral Scholarship Award

Donald W. ReynoldsCenter of Geriatric Nursing Excellence

Building Geriatric Nursing CapacityCrafting Solutions to Support Aging in Place

Reynolds 2018Predoctoral Scholarship Award*

Application

Instructions to Applicant

Read through all supplementary material (Overview, FAQs, Checklist, Reynolds Scholarship: Mentors Research Focus) prior to beginning the application process. Contact the Reynolds Center if you have questions:

405-271-1491, ext. 49233

Seek out an OU Reynolds Scholarship mentor as a primary step in developing this application. This should be done as soon as you determine interest in the Reynolds Predoctoral scholarship. Mentor Research Interests are included in the forms.

Fill in the Data Sheet, and then print it out. If you have difficulty accessing the Word form, open the alternative PDF form, print it and fill it out in black ink. Please note that all applicants must provide a second, permanent e-mail address.

Please note:

Incomplete applications will not be considered.

Additional items added to the application are not accepted. Submitting additional items or addenda or exceeding page limits may result in the removal of your application for consideration.

Completed applications and materials for the Reynolds Scholarship should be mailed to:

Donald. W. Reynolds Center of Geriatric Nursing Excellence

University of Oklahoma Health Sciences Center

1100 N. Stonewall Avenue

Oklahoma City, OK 73117

Att: Program Director

Deadline for Submission of ALL Application Materials: March 1, 5pm CST

Reynolds 2018 Predoctoral Scholarship Award

Data Sheet

Items in bold are REQUIRED.

A. GENERAL INFORMATION

Last Name / First Name / Middle Name
Date of Birth (Mo/Day/Yr) / Gender
Male Female / U.S. Citizen
Yes No
Ethnicity
American Indian/Alaska Native Native Hawaiian or other Pacific Islander
Asian White
Black or African American Other
Hispanic or Latino/Latina
Year of First Bachelor’s Degree
Mailing Address Line 1 / Home Telephone
Mailing Address Line 2 / Cell Phone
Home Address Line 1(if different from Mailing Address) / Primary Email Address
Home Address Line 2 / Secondary Email Address

B. PROGRAM REFERRAL

How did you find out about this scholarship award?

C. CREDENTIALS

D. RN LICENSURE – (At least one is required)

State(s) in which you are currently licensed as a Registered Nurse / RN License numbers

E. PROFESSIONAL BACKGROUND

Present Position
Present Institution
Mailing Address Line 1
Mailing Address Line 2

F. RESEARCH PROGRAM

Have you identified an area of research for your doctoral dissertation? (Required for all predoctoral students except those beginning their first year of study.)
Yes –Title______
______
No

G. OU REYNOLDS CENTER MENTOR INFORMATION

Last Name / First Name / Middle Name
Credentials / Position Title
Institution / Work Telephone
Mailing Address Line 1 / Fax Number
Mailing Address Line 2 / Work Email Address

Reynolds 2018 Predoctoral Scholarship Award

Checklist

Data Sheet /

Basic identifying information.
Provide both your primary and secondary e-mail addresses.

Professional Development Plan for Scholarship Period

12 point Arial font.
1 inch margins.
5-7 pages double spaced.

/ Professional development plan must include:

Introduction tracing your personal and professional interest in geriatric nursing (500 words or less).
Summary of any previous geriatric or research training and experience.
Proposed research and leadership goals for the Reynolds Scholarship award timeframe (24 months).
Anticipated research and leadership competencies to be attained during the award timeframe.
An identified mentor at University of Oklahoma College of Nursing Reynolds Center with rationale that his/her background is appropriate for the applicant’s research focus (see list of Reynolds Mentors).
Long-term (10 – 15 years) plans. “Where do you see yourself in 15 years?”

Scholars are expected to devote full time (minimum of 40 hours/week) to their professional development plan and research.
Scholars are not permitted to work more than .5FTE during the Scholarship period. Where some work activities are to be undertaken during the scholarship period, they must be carefully and fully described in the application.
Letter of Commitment from the Mentor Including Mentor’s 4-page NIH Format Bio-sketch

No specific format required for this letter.
Letter should be addressed to and mailed directly to the Reynolds Center Program Director.
Letter must be received by the due date for the Reynolds Scholarship application.

A letter from the University of Oklahoma College of Nursing Reynolds Center mentor who agrees to support and advise the applicant in implementing the scholarship development plan.
Letter should include a detailed proposal for involvement in the applicant's professional development; activities planned to develop the applicant’s competencies in research and leadership; and strategies to help the applicant form linkages with relevant colleagues and institutions.
Include each mentor's NIH-formatted 4-page bio-sketch.
The Center reserves the right to contact the mentor for additional information.

Letter of Commitment from Employing Agency (if applicable)

No specific format required for this letter.
Letter should be addressed to and mailed directly to the Reynolds Center Program Director.
Letter must be received by the due date for the Reynolds Scholarship application.

If applicant plans to work during the Scholarship period, the employer must provide a letter describing sufficient release time to allow full time commitment to the Scholarship program.
Scholars are not permitted to work more than .5FTE (half time) during the Scholarship period. See Professional Development Plan for more information.

Applicant’s Curriculum Vitae /

Include current document that includes education, professional experience, research, publications, special achievements, and professional service activities.

Academic Transcripts
IF the applicant is applying to the OU PhD in Nursing program, the Selection Committee will review transcripts that are submitted with the PhD Admission Application. No transcripts are included in this Scholarship application.
IF the applicant is currently enrolled in the OU PhD in Nursing program, include with this application an official OU transcript that incorporates all classes to date. /

Official transcripts from all post-secondary education institutions.

References
If you are applying to the OU PhD in Nursing program, the Reynolds Selection Committee will retrieve and review the three letters of reference submitted with the PhD application.

These letters are NOT included in this application.
Letters must be received by the due date for the Reynolds Scholarship application.

If you are an already-enrolled doctoral student in the OU PhD in Nursing program, you MUST submit three new references in support of this scholarship application. No specific format is required for this letter.

Letters should be addressed to and mailed directly to the Reynolds Center Program Director.
Letters must be received by the due date for the Reynolds Scholarship application.

The three reference letters will be reviewed with interest in potential of the applicant to complete the program and specific evidence of the applicant’s potential for academic and professional leadership in the field.

Donald W. Reynolds Center of Geriatric Nursing ExcellencePage 1

University of OklahomaHealthSciencesCenter

1100 N. Stonewall Avenue Oklahoma City, OK 731171/19/2019 9:50 PM

Phone: 405-271-1491 (ext 49209) Fax: 405-271-7714

Center Contact Staff: